Common questions about dexamethasone tablets and liquid - Brand names: Neofordex, Glensoludex, Martapan

Dexamethasone is a steroid (also called a corticosteroid) medicine.

Steroids closely copy the effects of natural hormones produced in your adrenal glands. The adrenal glands are above your kidneys.

When prescribed in doses higher than your body's usual levels, steroids like dexamethasone reduce inflammation (swelling). This can help the symptoms of inflammatory conditions, such as croup, arthritis and asthma.

Steroids also help calm your immune system. This can help in autoimmune conditions like rheumatoid arthritis, where your immune system mistakenly attacks your own tissues.

When taken for nausea and vomiting dexamethasone is thought to work on chemical messengers in the brain to reduce feelings of sickness.

Dexamethasone is being used to treat severe COVID-19 in hospitals.

For patients on a ventilator or who need oxygen to help them breathe, dexamethasone can improve their chances of recovery.

There's no evidence to suggest that dexamethasone will help in less serious COVID-19 when people do not need to be in hospital.

It does not stop you getting COVID-19 and it may not stop mild symptoms getting worse.

This can vary depending on why you're taking dexamethasone.

For some conditions, you will feel better after a couple of days.

For other conditions, you may not feel any better even though the medicine is helping you.

Ask your doctor what to expect for your condition.

If you take dexamethasone for several months it can make your bones weaker and more likely to break (osteoporosis).

You can also get eyesight problems and it can cause slower growth in children and teenagers.

If you have diabetes, dexamethasone can affect blood sugar control. Your doctor may need to adjust your diabetes treatment while you take this medicine and again after you stop.

However, there are steps you can take to help you stay as healthy as possible.

For healthy bones

Take regular exercise and make sure you get enough calcium in your diet to help strengthen your bones. Calcium-rich foods include milk, cheese and leafy green vegetables. To check your bones, your doctor may arrange for you to have an occasional bone scan.

For diabetes

If you have diabetes you may need to check your blood glucose more often. Your doctor can give you more advice about this.

For eye health

To reduce the chances of eyesight problems, visit an optometrist every 12 months. They'll check for high pressure in your eye (glaucoma) and cataracts.

For children and teenagers

If your child takes dexamethasone for several months, their height and weight need to be monitored carefully. This is to make sure the steroid is not affecting their growth. Talk to their doctor if you're worried. They'll be able to explain the benefits and risks of giving your child dexamethasone.

Do not stop taking dexamethasone suddenly, especially if you've been on a high dose for a long time.

Your health condition may flare up again.

You may also get extra side effects including:

• severe tiredness
• weakness
• body aches
• joint pain

Your doctor will probably want to reduce your dose gradually over several weeks to prevent these side effects.

If you need any vaccinations, let the doctor or nurse know that you're taking a steroid.

Some types of vaccines, known as live vaccines, are not suitable while you're taking dexamethasone. This is because taking dexamethasone affects your immune system, so you're more at risk of infection caused by a live vaccine.

Live vaccines include the oral typhoid vaccine and the BCG vaccine for tuberculosis.

There are non-live versions of vaccines available for conditions including flu, shingles and polio. These are safe to have while you're taking dexamethasone.

Red steroid emergency card

If you're prescribed steroid medicines such as dexamethasone, your adrenal glands may not make as much of some of the hormones your body needs such as cortisol (known as the stress hormone). This is known as adrenal insufficiency.

It's more likely to happen if you either:

• take high doses for a long time, especially tablets and injections
• regularly use different kinds of steroids at the same time, such as a steroid nasal spray and a steroid inhaler

Your doctor or pharmacist will assess your risk of adrenal insufficiency based on the type and dose of steroids you're taking and may recommend that you carry a red steroid emergency card. This card is the size of a credit card and fits in your wallet or purse.

The Addison's Disease Self-Help Group (ADSHG) website has more information about the NHS steroid emergency card.

Blue steroid card

If you take dexamethasone for longer than 3 weeks, or you take more than 6mg a day, your doctor or pharmacist will give you a blue steroid treatment card.

It tells you how you can reduce the risks of side effects. It also gives details of your doctor, how much dexamethasone you take and how long the treatment will last for. The card is the size of a credit card and fits in your wallet or purse.

If you need any medical or dental treatment, show your blue steroid card to the doctor or dentist.

There are other steroids available, including:

• deflazacort
• methylprednisolone
• prednisolone
• prednisone

For most health problems, these steroids are very similar to dexamethasone in terms of how well they work and how safe they are.

Taking dexamethasone makes you more likely to catch infections such as flu, COVID-19, the common cold and chest infections. Tell your doctor if you get symptoms of an infection or test positive for COVID-19.

Keep away from people with an infectious illness, especially measles, chickenpox or shingles. If you get any of these illnesses they could make you very ill.

Tell your doctor straight away if you come into contact with someone who has chickenpox, shingles or measles. Your doctor may be able to prescribe a medicine to protect you.

Dexamethasone will not affect any type of contraception, including the combined pill or emergency contraception.

Dexamethasone does not make you sleepy and so it's usually safe to drive or ride a bike while taking this medicine.

However, do not drive, cycle or operate machinery if your eyesight is affected.

Yes, you can drink alcohol while taking dexamethasone.

No, you can eat and drink normally while taking dexamethasone.